Sandgate Manor

Updated 13 April 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was undertaken by 2 inspectors, 1 medicines inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Sandgate Manor is a “care home”. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Sandgate Manor is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager was in post and was preparing to apply to register.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought and received feedback from health and social care professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 12 people who used the service and 2 relatives about their experience of the care provided. We observed how staff interreacted with people in areas such as the lounges and dining areas. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not or chose not to talk with us.

We spoke with 12 members of staff including the managing director, the manager, the house manager, the cook, senior care staff and care staff.

We reviewed a range of records. This included all or parts of 12 people’s care records and medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed.

Updated 13 April 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. “Right support, right care, right culture” is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Sandgate Manor is a care home providing accommodation and personal care to 18 people at the time of the inspection. The service can support up to 22 people. Support was provided to people who lived in one adapted building and there were 3 single person lodges in the grounds. Some people had learning disabilities and or autism, other people received support for physical disabilities.

People’s experience of using this service and what we found

Right Support:

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. There were no plans in place to support people to maintain or increase their independence. However, the service was in the process of making improvements to increase accessibility for people and some improvements had already been made.

Staff did not always support people to achieve their aspirations and goals. Processes to do this effectively required review, as goals and aspirations had not been formally assessed. People’s sensory needs had not been assessed.

People received their medicines as prescribed. Staff enabled people to access specialist health and social care support in the community. Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs.

People were supported to engage in activities. Improvement was still needed; however, staff were working towards this.

Right Care:

People’s support plans did not always reflect their range of needs as care plans were not up to date and did not include some important information.

Equality and diversity needs had not been assessed to provide people the opportunity to share their views and enable staff to provide support. However, improvements had been made to protect one person’s human rights.

There had been improvements in how staff spoke to people and there were positive interactions between staff and people. Staff understood how to protect people from poor care and abuse and the service worked with other agencies to do so. Staff had training on how to recognise and report abuse and knew how to apply it.

Staff understood how people communicated. Where complaints had been received these had been investigated and acted upon. Staff had undertaken training in end of life care. However, end of life care planning needed to be reviewed.

Right Culture:

The management of incidents and accidents needed to be improved. Some incidents were acted upon. Further review was needed to ensure people were receiving the right support.

The new management team was putting improvements in place to address concerns. The office had moved into the main building which improved communication between managers and staff and gave the manager better oversight of the service.

Staff training had improved, and the new management team was making further improvements arranging for staff to attend further learning.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was rated inadequate (published 24 August 2022)

Following the last inspection, we issued Warning Notices for regulation 10, 12, 16 and 17. The provider also completed an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made. However, the provider remained in breach of regulations.

This service has been in Special Measures since 04 August 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of the report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the “all reports” link for Sandgate manor on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, promoting independence and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC”s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.